Study Of Midlife Women Research Articles

BIOLOGICAL AGE AND COGNITIVE PERFORMANCE AMONG LATE MID-LIFE WOMEN

Abstract Older biologic age, indicated by accelerated epigenetic aging, may place women at risk for poorer cognitive performance as they age. However, findings are inconsistent and based upon limited neuropsychological batteries. Studies of midlife women are few, yet women comprise two thirds of those with Alzheimer’s disease, and midlife is a critical transition and potential window for early intervention. We tested whether greater epigenetic age would be associated with poorer cognitive performance among late midlife women. 224 MsBrain study participants (average age=59 years, 82% White, 14% Black, 4% other ethnicities) underwent phlebotomy, including epigenetic aging clock estimates (GrimAge, DunedinPACE, PCPhenoAGE), and a neuropsychological battery assessing global cognitive function (Montreal Cognitive Assessment), verbal learning and memory (California Verbal Learning Test), working memory and attention (Letter Number Sequencing), letter fluency (P, R, W); semantic fluency (animal task), spatial ability (Card Rotations), processing speed (Symbol Digit Modalities Test), and perceptual speed (Finding A’s). In linear regression models controlling for age, race, and education, older PCPhenoAge was associated with poorer global cognitive performance [B(SE)=-.07(.03), p=.01], verbal memory [B(SE)=-.09(.03), p=.006], working memory [B(SE)=-.12(.03), p=.0001], attention [B(SE)=-.10(.04), p=.02], spatial ability [B(SE)=-.77(.34), p=.02], processing speed [B(SE)=-.24(.09), p=.007], and somewhat lower letter fluency [B(SE)=-.23(.13), p=.07]. GrimAge and DunedinPACE showed similar yet less consistent patterns. Interactions by race (p’s<.05) indicate that associations between older biologic age and poorer cognitive performance (verbal learning, verbal memory, processing speed) was particularly pronounced among Black women in the sample. Older biologic age is associated with poorer cognitive performance across multiple domains among late midlife women, particularly for Black women. Biologic age may serve as an early indicator of risk that could help identify women warranting early intervention to help maintain cognitive function. Supported by NIH RF1AG053504, R01AG053504, K24HL123565

Age, Attitudes to Aging, and Identity in Older Canadian Women

The life course perspective emphasizes social structure, personal agency, and their interdependencies (Settersten et al., 2020), serving as the theoretical framework for this study. Given stereotypical societal views of gender and aging (e.g., Sontag, 1979), physical aging is often the focus when examining women’s aging attitudes and concomitant changes in a sense of personal identity. Additionally, studies of midlife women have found relationships between age and identity (e.g., Stewart et al., 2001). Using quantitative and qualitative data, the present study examines associations between age, personal identity, and attitudes to physical, psychological and social aging in older Canadian women (N = 190, Mage = 70.38). Results show that while attitudes to physical aging contribute to identity maintenance, attitudes to social and psychological aging are also important for older women’s identity maintenance. Interactions between age and attitudes to aging associated with personal identity are discussed with reference to the life course perspective.

Risk factors associated with coronary artery calcification in midlife women: a population-based study

The aim of this study was to investigate the association between individual risk factors and coronary artery calcification (CAC), as a marker of subclinical cardiovascular disease, in a population-based nested cross-sectional study of midlife women. Anthropometric and metabolic data from 295 women from the South of Brazil were analyzed. Habitual physical activity was assessed by pedometer. CAC was assessed by a multi-detector computed tomography system. Average Agatston score was used to stratify participants as CAC > 0 and CAC = 0. Women with CAC > 0 (34.7%) were older (58.7 ± 5.4 vs. 56.3 ± 5.2 years, p < .001) and had higher prevalence of central adiposity (71 vs. 59%, p = .04) and hypertension (71 vs. 52%, p = .002) than women in the CAC = 0 group. Hormone therapy (HT) was more prevalent in the group with CAC = 0 (19.7 vs. 9.8%, p = .029). The prevalence ratios for CAC > 0 were 0.545 (95%CI:0.309–0.962, p = .036) for HT and 1.752 (95%CI:1.207–2.541, p = .003) for hypertension, after adjustment for age, educational level, smoking, alcohol intake, and physical activity. The present data in a population-based sample of midlife women indicate that hypertension and age were positively associated with higher risk for CAC > 0 and HT was related with CAC = 0.

Menopausal hormone therapy and sleep-disordered breathing: evidence for a healthy user bias

PurposeObservational studies suggest that menopausal hormone therapy protects against sleep-disordered breathing, but such findings may be biased by a “healthy user effect.” When the Women's Health Initiative Study reported in 2002 that estrogen-progestin therapy increases heart disease risk, many women discontinued hormone therapy. We investigate healthy user bias in the association of hormone therapy with sleep-disordered breathing in the Sleep in Midlife Women Study. MethodsA total of 228 women aged 38 to 62 years were recruited from the Wisconsin Sleep Cohort Study. They underwent polysomnography to measure apnea-hypopnea index, at home semiannually from 1997 to 2006, and in the sleep laboratory every four years (n = 1828 studies). Hormone therapy was recorded monthly. Linear models with empirical standard errors regressed logarithm of apnea-hypopnea index on hormone use with a pre- or post-July 2002 interaction, adjusting for menopause and age. ResultsThe association of hormone therapy and sleep-disordered breathing was heterogeneous (P < .01); apnea-hypopnea index among users was 15% lower in the early period (95% confidence interval, −27% to −1%), but similar to nonusers in the late. ConclusionsHormone therapy was negatively associated with sleep-disordered breathing only until the Women's Health Initiative results were publicized. Hormone therapy may have been a marker for healthfulness in the early period, creating a spurious association with sleep-disordered breathing.

Disordered eating among mid-age women: is quality of life impacted over time?

Objective This longitudinal study of midlife women has three aims: examine quality of life (QoL) among women with and without indicators of disordered eating (DE); compare the obtained QoL effect to a younger cohort in the same longitudinal study and investigate potential moderating effects of depression and social support on the relationship between DE and QoL. Method We used self-report data from six waves of the Australian Longitudinal Study on Women s Health over 14 years. A total of 12,338 women participating in the mid-age cohort (ageing from 45-50 to 59-64) provided self-report indications of DE at Surveys 1 and 2, and QoL (SF-36 component scales - mental [MCS] and physical [PCS]) at Surveys 2-6. Results DE was reported by 10.25% of the women who also reported significantly poorer mental and physical QoL than those without DE; this effect was sustained over 12 years. Effect size differences for the midlife and younger women, between those with and without DE, showed a larger impact on physical QoL over time for the mid-age women. Midlife women with high levels of depressive symptoms (with and without DE) had the lowest initial mental QoL scores. Midlife women with high depression and DE had the greatest increase in mental QoL over time, but their mean score was still considerably lower than all other groups. Conclusions This study underscores the significant effect of midlife DE on QoL, particularly when comorbid with depression, suggesting specific support options are needed for mid-age women.

Managing Depression During the Menopausal Transition

The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling implications for assessment, education, advocacy, and self-care are discussed. ********** Women are diagnosed with depression at nearly twice the rate as men are (American Psychiatric Association [APA], 2000), a trend that begins in puberty (APA, 2000) and levels off after menopause (Bebbington et al., 2003). Without question, rates of depression in women are higher during their reproductive years. Although the connections between depression and premenstrual syndrome and the postpartum period are recognized and included in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; APA, 2000), no such recognition exists for depression during the menopausal transition. Failing to recognize a potential biological component of a disorder and instead emphasizing psychosocial or intrapsychic factors can lead to treatment that is ineffective, if not harmful. Therefore, the purpose of this article is threefold: to discuss hormonally based factors associated with depression during the menopausal transition; to review the benefits and risks of hormone replacement therapy (HRT), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and complementary and alternative medicine (CAM) approaches to treat depression; and to offer strategies for assessment, advocacy, and intervention. THE MENOPAUSAL TRANSITION AND RISK OF DEPRESSION Efforts to understand possible relationships between depression and reproductive cycles in women consistently point to a strong connection between the menopausal transition and increased occurrences of depression. In a critical review of the research literature, Soares and Zitek (2008) concluded that the menopausal transition seems to present a unique period in which some women are more vulnerable to initial onset or recurrent depressive symptoms and major depressive episodes. Similarly, Schmidt (2005) affirmed that research studies indicate a relationship between perimenopause (the early and late stages of the menopausal transition) and the onset of depression, a relationship that did not extend to the postmenopausal stage. Deecher, Andree, Sloan, and Schechter (2008) likewise concluded that clinical studies show an increase in major depressive disorder during perimenopause compared with such occurrences during premenopause or postmenopause. The authors found that this increased risk was present even in perimenopausal women who had no prior history of major depressive disorder. Findings from longitudinal studies illustrate these conclusions. Results from the Seattle Midlife Women's Study, a prospective study that followed women for approximately fourteen years, showed that the late menopause transition stage was significantly related to depressed mood (Woods et al., 2008). Results were similar for cohorts from another prospective study, the Penn Ovarian Aging Study, an ongoing longitudinal study (as cited in E. W. Freeman et al., 2004). An examination of a 4-year cohort from this study showed that depressive symptoms increased during the menopausal transition and decreased in postmenopause (E. W. Freeman et al., 2004). E. W. Freeman, Sammel, Lin, and Nelson (2006) examined another cohort over an 8-year period from the Penn Ovarian Aging Study. They found that a woman was 4 times more likely to have high depression scores and 2 1/2 times more likely to be diagnosed with depressive disorder when she was in the menopausal transition compared with her premenopausal period. Although no direct associations have been identified in the research between depression during the menopausal transition and specific levels of hormones (e. …

Women's midlife symptom-reporting in China: Cross-cultural analysis

This report draws on data from the author's China Study of Midlife Women (CSMW) to test the popular notion that East Asian women have a low level of midlife symptom reporting compared with North American women. Symptom-reporting frequencies from a general population sample of 156 Chinese women of age 45-55 in China are compared with rates from published studies on midlife women in Japan, Canada, and the U.S. While the Japanese women's rates of reporting 16 core symptoms are uniformly low, the Chinese women's frequencies range from low to moderate. Except on hot flashes and headaches, the Chinese women's symptom-reporting rates tend to be more similar to the North American than to the Japanese sample. This analysis demonstrates that women's midlife symptom reporting in China cannot be equated with findings on women in Japan. Sources should be more cautious in making generalizations about East Asian women in this regard.

Chinese women's symptoms: relation to menopause, age and related attitudes

Objectives The China Study of Midlife Women (CSMW) aimed to determine in mid-life Chinese women, first, the frequency of various symptoms often included in studies of menopause or the climacteric, second, attitudes toward menopause and aging, and, third, the relationship between symptoms and menopausal status, chronological age and attitudes.Methods A questionnaire was administered via face-to-face interview to a general population sample of 399 Chinese women living in two communities in northern China.Results The Chinese women displayed a low to moderate frequency of reporting 21 symptoms across vasomotor, vaginal, sleep-related, cognitive, emotional and somatic categories. Their attitudes toward menopause and aging tended to be more positive, neutral or ambivalent, as opposed to negative. There was a small, statistically significant association between six symptoms and menopausal status, four symptoms and chronological age, and 11 symptoms and negative attitudes toward menopause and aging.Conclusions Across the measures utilized in this study, Chinese women's symptom reporting is more strongly associated with their attitudes towards menopause and aging than their menopausal status or chronological age. More research is needed on cross-cultural, cross-ethnic and individual variation in women's interpretations of statements often included in mid-life attitudinal scales.

A Study of Midlife Women's Reasons for Changing Healthcare Providers

The purpose of this study was to examine the reasons midlife women report for changing healthcare providers and to determine if there were any differences in reasons given for the change based on gender or ethnicity. This was an analysis of data collected from a healthy community-based sample of midlife women as part of a longitudinal 5-year study of changes in health outcomes during transition to menopause. Women were queried about their experience in changing healthcare providers. Over 42% indicated that they had changed health providers because of dissatisfaction with care. The component accounting for the majority of the variance was related to communication issues. There were no significant differences across ethnic groups in decision to change providers or in reasons for their dissatisfaction with care. However, their reports of experiencing racism in the healthcare system were troubling. The ability of the provider to communicate with women may have implications in women's choices in health care later in life.

Changing Health Care Providers: A Study of Midlife Women

Changing Health Care Providers: A Study of Midlife Women

Changing health care providers: A study of midlife women

Changing health care providers: A study of midlife women

Sexual functioning and practices in a multi‐ethnic study of midlife women: Baseline results from swan

This study examined the sexual practices and function of midlife women by ethnicity (African American, Caucasian, Chinese, Hispanic, Japanese) and menopausal status. Sexual behavior was compared in 3,262 women in the baseline cohort of SWAN. Participants were 42 to 52 years old, premenopausal or early perimenopausal, and not hysterectomized or using hormones. Analysis used multivariate proportional odds regression. In our sample, 79% had engaged in sex with a partner in the last 6 months, and a third considered sex to be very important. Common reasons for no sex (n = 676) were lack of partner (67%), lack of interest (33%), and fatigue (16%). Compared with Caucasians, Japanese and Chinese women were less likely, and African Americans more likely, to report sex as very important (p < 0.005). Significant ethnic differences were found for frequency of all practices. Perimenopause status was associated only with higher frequencies of masturbation and pain during intercourse.

THE OHIO MIDLIFE WOMEN'S STUDY

The Ohio Midlife Women's Study was longitudinal with measurements occurring at three, 9-month intervals. Our purpose in doing this research was to examine predictors, moderators, and outcome variables associated with the transition to midlife in Caucasian and African American women. Predictor variables included loss and gain of resources. Moderators included menopause symptoms, menopausal status, attitude toward menopause, coping, and demographic characteristics. Outcome variables included anxiety, depression, and health promoting activities. To obtain the proposed final sample of 160 midlife women, an initial sample of 103 African American and 105 Caucasian "healthy" women were recruited in the community. Consistent predictors of anxiety were loss of resources, coping effectiveness, and education. Consistent predictors of depression were loss of resources and education. Health promoting activities were consistently predicted by attitude toward menopause and coping effectiveness. Stress is a better predictor of negative health outcomes than menopausal status.

Dimensions of Sexuality in the Perimenopausal Transition: A Model for Practice

A biopsychosocial-cultural model of the sexuality of women during the perimenopausal transition includes dimensions related to physiology, psychosocial issues, and culture. It is an amalgam of biomedical and psychosocial models, yet has the added focus on culture. This holistic approach to sexual health is recommended by researchers and clinicians engaged in the study of midlife women. Clinicians can use this model to guide assessment and interventions, examining all of the dimensions of sexuality during the perimenopausal transition.

Locus of Control and Marital Termination:

Data from a nationally representative, longitudinal study of mid-life women were used to examine whether termination of marriage was associated with change in locus of control orientation. Comparisons before and after termination were drawn for divorced and widowed women and those who remained married. In contrast with previous research, both descriptive statistics and co-variance analysis revealed that locus of control was stable following transitions out of marriage and their associated changes in lifestyle, family relations, economics, etc.